足外伤的显微外科处理及功能恢复

目的:总结应用显微外科技术处理足部外伤的经验。方法:对44例伤情不同的患者,其中男39例,女5例。年龄6个月~58岁,平均27.2岁。伤后30分钟~14小时就诊。手术方式:利用显微外科技术进行肌腱神经吻合术、吻合血管的股前外侧皮瓣移植术、带腓动脉的小腿逆行岛状皮瓣转移术、断足再植、游离植皮术及骨折复位内固定术等。结果:术后随访6个月~2年,21例肌腱断伤者,19例恢复正常,2例肌腱粘连。14例有神经断伤者,2例出现爪形趾,痛觉减退,12例基本恢复正常。17例骨折术后3个月~6个月骨折愈合。5例足部软组织缺损,足功能恢复正常。结论:应用显微外科技术修复足部外伤可明显提高足部功能恢复。     

mini-Swashbuckler入路联合股骨外侧微创内固定系统治疗股骨远端骨折患者的效果

目的：观察mini-Swashbuckler入路联合股骨外侧微创内固定系统（LISS）治疗股骨远端骨折患者的效果。方法：选取80例股骨远端骨折患者为研究对象,按照随机数字表法分为对照组与观察组各40例。对照组采用传统Swashbuckler入路联合LISS治疗,观察组采用mini-Swashbuckler入路联合LISS治疗,比较两组临床相关指标水平、膝关节功能[美国特种外科医院膝关节功能（HSS）]评分、并发症发生率和生命质量[简明健康状况调查量表（SF-36）]评分。结果：观察组手术时间长于对照组,术中出血量少于对照组,差异有统计学意义（P<0.05）;两组住院时间和骨折愈合时间比较,差异无统计学意义（P>0.05）;术后3、6个月时,观察组HSS评分均高于对照组,差异有统计学意义（P<0.05）;观察组并发症发生率为5.00%(2/40),与对照组的10.00%(4/40)比较,差异无统计学意义（P>0.05）;术后6个月,两组SF-36评分均高于术前,且观察组高于对照组,差异有统计学意义（P<0.05）。结论：mini-Swashbuckler入路...     

2003-2012年全国新生儿遗传代谢病筛查室间质量评价结果分析

目的 总结并分析2003-2012年全国新生儿筛查实验室检测苯丙氨酸(phenylalanine,Phe)和促甲状腺素(thyroid stimulating hormone,TSH)室间质量评价(external quality assessment,EQA)结果,为进一步提高我国Phe和TSH检测水平提供有价值的参考。方法 参照美国疾病控制中心(CDC)新筛质量保证计划和中华人民共和国国家标准GB/T 20470-2006《临床实验室室间质量评价要求》。每年进行3次EQA,每次发放5个质控血片,要求各筛查实验室在规定时间内检测,回报Phe和TSH浓度水平结果及临床定性判断结果;组织者对所有回报的结果进行统计分析,作出实验室检测水平的评价。结果 2003-2012年测定Phe荧光分析法所占比例为54.9%~85.2%、定量酶法和细菌抑制法分别为12.6%~6.2%和35.4%~4.6%;测定TSH时间分辨荧光分析法(Tr-FIA)所占比例为44.8%~70.7%、酶联免疫分析法(ELISA)和荧光酶免疫分析法(FEIA)分别为36.0%~11.2%,17.5%~13.0%。十年来Phe 150个批号实验室间平均变异系数分别为12.13%(定量酶法)、17.15%(细菌抑制法)、12.14%~12.97%(荧光法);TSH 150个批号实验室间平均变异系数:Tr-FIA为14.14%,ELISA 为14.88%~27.20%,FEIA为17.07%~34.98% 。2003-2012年间Phe和TSH浓度水平检测的平均合格率分别为95.3%和89.4%,临床定性判断平均合格率分别97.8%和98.0%。 结论 目前Tr-FIA成为我国筛查实验室测定TSH的首选方法,荧光分析法明显优于细菌抑制法。开展全国新生儿遗传代谢病Phe和TSH室间质量评价工作,有助于筛查实验室发现检测中存在的问题,逐步提高国内新生儿遗传代谢病检测质量水平。     

中医药浴疗法发展源流与机理探析

阐述了药浴疗法的发展源流,发现早在殷商时期已有使用,《黄帝内经》奠定了其理论基础,《伤寒杂病论》中多有应用,至隋唐时期随中医外科的发展逐步兴盛,广泛用于内外妇儿各科及养生保健领域,至明清时期,基本形成较为完备的药浴理论与应用体系.历代医家多认为药浴疗法属汗法范畴,具有发汗、开腠理、调和血脉的作用,现代对药浴疗法的理解、...     

基于《黄帝内经》营卫理论探讨不安腿综合征

基于《黄帝内经》(《内经》)理论,分析不安腿综合征的临床特点,认为本病与中医学肉苛、肉烁、足悗等病证有关;运用营卫运行节律分析,本病基本病机为营卫失和,气血不调;其病位在筋肉,故责之肝脾不调.不安腿综合征病因复杂,病情迁延难愈,符合《内经》"因加而发,合邪为患"的发病观,即外感风寒湿邪,内有营卫气血失和与肝脾功能失调,...     

Inter-brain synchronization is weakened by the introduction of external punishment

Punishment is a popular institution to enforce social norms in human society. However, how the punishment institution impacts the inter-brain neural signatures of two-person social interactions is still an open question. By performing electroencephalography recording of brain activity in two interacting parties as they simultaneously played both the revised repeated ultimatum game (rrUG) and the revised repeated dictator game (rrDG), this study focused on exploring how the introduction of external punishment influences inter-brain synchronization between the two parties. The data showed a significant negative effect of external punishment on inter-brain synchronization, with greater inter-brain synchronization observed in the rrDG than in the rrUG. We proposed a possible mechanism underlying this result. In the rrDG, the similar moral motivation of both proposers and responders results in inter-brain synchronization between them. However, in the rrUG, the introduction of external punishment crowds out the intrinsic moral motivation of the proposers, thereby undermining the inter-brain synchronization. Moreover, we found a significant positive correlation between the rejection rate from responders for disadvantageous inequal offer and inter-brain synchronization in the rrDG. These findings contribute to understanding the negative effect of punishment institution and shed light on the inter-brain mechanism underlying social interaction.     

清营方中药熏洗结合疮面缠缚治疗臁疮疗效观察

目的观察清营方熏洗疮面结合疮面缠缚治疗臁疮的临床疗效。方法将60例臁疮患者分为2组,治疗组30例采用疮面敷药加缠缚治疗,同时予以自拟清营方熏洗溃疡疮面,对照组30例采用疮面敷药加缠缚治疗。治疗3个月后观察2组临床疗效、溃疡疮面愈合时间及溃疡复发率。结果治疗组临床治愈率90%,溃疡愈合时间为12～112 d,溃疡复发率8%;对照组临床治愈率77%,溃疡愈合时间为16～149 d,溃疡复发率29%。治疗组的临床治愈率、溃疡愈合时间均优于对照组,溃疡复发率低于对照组。结论清营方中药熏洗结合疮面缠缚治疗臁疮效果更好。     

Associations between Abnormal Eating Styles and Irritable Bowel Syndrome: A Cross-Sectional Study among Medical School Students

(1) Background: Few studies have investigated the association between eating styles and IBS. This study aimed to explore the association between abnormal eating styles and irritable bowel syndrome (IBS). (2) Methods: This cross-sectional study investigated students in China Medical University and Shenyang Medical College. Eating styles were evaluated by the Dutch Eating Behavior Questionnaire (DEBQ), and IBS was diagnosed according to Rome III criteria. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). (3) Results: A total of 335 students were diagnosed with IBS. Students with the total scores in tertile 2 and 3 had 1.29 times and 2.75 times higher risk of IBS than students with the total scores in tertile 1, respectively. Simultaneously, the risk of IBS in the tertile 3 of external eating, emotional eating, and restraint eating trends was 3.87 times, 2.71 times, and 3.82 times higher than that of tertile 1, respectively. (4) Conclusions: this study showed that a high score in both total eating styles and each eating style was associated with the odds of having IBS and suggested that the psychological factors behind eating styles may play a critical role in controlling the IBS.     

菱形切口外剥内扎注射术治疗混合痔100例临床研究

目的研究菱形切口外剥内扎注射术治疗混合痔的临床价值。方法将200例混合痔患者随机的分为两组,每组100例,菱形切口外剥内扎注射术为治疗组和对照组外剥内扎术进行对比观察。结果治疗组在术后继发出血,术后尿潴留及疗效方面与对照组比较无统计学意义（P〉0.05）,但在术后疼痛、术后肛门功能影响、伤口愈合时间、复发等方面比较有统计学意义（P〈0.05）。结论菱形切口外剥内扎注射术治疗混合痔在术后疼痛情况、术后肛门功能影响、伤口愈合时间以及复发等方面优于外剥内扎术。     

股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全

目的:评估应用股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全的疗效.方法:对原发性下肢深静脉瓣膜功能不全的55例患才施以股浅静脉第一对瓣膜包窄术,包窄材料选用聚四氟乙烯人造血管.结果:本组病人术后均随访4-14个月,术前临床症状缓争,疗效好,结论:股浅静脉第一对瓣膜包窄术治疗瓣膜轻,中度倒流的原发性下肢深静脉瓣膜功能不全,有坚实的理论基础,并有并发症少,操作简单,疗铲好等优点,值得推广.